DISCLAIMER: The cases / examples on this blog have been anonymised to maintain confidentiality of patients. Cases have been acquired from various international hospitals and through other medical colleagues with the intention to teach through case examples.

Tuesday, 17 August 2010

Yes, it's been 6 months since I last put finger tips to keys to write on this blog. I have been busy with many things :-)

Since I last wrote, the iPad and the iPhone 4 have come on to the market.

The iPad is a really neat device albeit somewhat heavy. The screen is a nice size but grainy unlike the new iPhone 4 retina display. But, it makes a great eBook reader, word processor, newspaper reader etc. However, I think it has many more uses including within medicine.

It can potentially be used to 'clerk' patients. That means it can be used to record the patient interview and physical findings etc. Basically, a portable electronic patients records device that can upload to the main system for synchronising data. From my experience of seeing Japanese patient record softwares, they are cumbersome and complicated. Also, you either have to have a PC desktop or a laptop. Use of a laptop even at the patient bedside is cumbersome and the battery last about 4 hours if you are lucky ! Usually, it's about an hour in reality as someone else has used the machine without plugging it in.

The iPad has a 10 hour battery after a four hour charge and it much lighter than a laptop. With the touch screen technology, you can tap boxes referring to positive or negative findings, draw diagrams, add voice notes etc This cannot be down so easily or so cheaply on the current PC technology. The iPad is cheap enough and advanced enough to take medicine into a new era where the doctor can be freed up to see the patients at the bedside rather than being tied to the nurse station where the PCs are.

In the 'good old days' the papers notes meant that you could write the patient notes directly at the bedside and define an immediate plan and decide on your tests. But, there was never a way to make that information immediately known to relevant members of the team if they were in another location. Also, it meant that in order to see something relevant in the notes everyone would have to crowd around the patient notes. With the iPad, if every member of staff had such a device, all team members could read the notes simultaneously, check the lab data and radiology on the move from patient to patient so that problems are not missed.

Taking an iPad to the bedside and clerking the patient melds the old with the new and allows immediate updates for the patient care.

Now all that is needed is for some clever software makers to liaise with what physicians need and to make a package in Japanese to allow the doctors to be freed up to practice medicine at the bedside. Such software could also include the 'Review of Systems' with check boxes that would then organise the data later on to auto generate problem lists so that the physician does not overlook the information.

Integration with other software packages that could generate a differential diagnosis would be the next step but let's get 'denshi kalte' made portable first and bring medicine into the new age of technology the way it should have always been!